Hospital and its organization ppt.pptx

Hospital and its organization

1. Hospital and its organization

2. Definition of Hospital WHO Expert Committee, 1963: ‘ A hospi t al i s a r e s i de n tial e st ablishme n t w h ich provides short-term and long-term medical care consisting th e r apeu t ic of o b se r v a t i on a l, diagn o s t i c, a n d r ehab i li t a ti v e se r vices f or persons suffering or suspected to be suffering from a disease or injury and for parturients. It may or may not also provide services for ambulatory patients on an out-patient basis’.

3. WHO expert committee, 1956: ‘The hospital is an integral part of a social and medical organization, the function of which is to provide for the population complete healthcare, both curative and preventive, and whose out- patient services reach out to the family in its home environment; the hospital is also a centre for the training of health workers and for bio- social research’.

4. FUNCTIONS OF HOSPITAL To uplift quality of law and general standards of medical practice. To provide facilities & guidance , by which persons can work in groups, with the intention of betterment of hospital department, patient & community. T o reduce disease occurrence by early diagnosis and treatment. T o estimate needs for facilities, supplies & equipment's, and their utilization for evaluation, control & maintenance. To estimate departmental necessities.

5. MA K ERS COMPETENT STAFF To PROVIDE a COMMON LINK between GENERAL PUBLIC & POLICY To SUGGEST POLICIES & PROCEDURES to maintain ADEQUATE & To DEVELOP & MAINTAIN an effective system of CLINICAL & ADMINISTRATIVE RECORDS & REPORTS . To HARNESS growth of MEDICAL SCIENCE , by PROPER TRAINING of DOCTORS & NURSES in large training hospitals . To CREATE & DEVELOP FINANCIAL PLAN for the OPERATION OF HOSPITAL .

6. To provide facilities for continuing EDUCATION of all the people . To PARTICIPATE & IMPLEMENT SAFETY PROGRAMMES of HOSPITAL . To INITIATE, UTILIZE & PARTICIPATE in RESEARCH PROJECTS , aimed at IMPROVEMENT of PATIENT CARE , and other hospital s e r v i c e s .

7. Classification of Hospital 1. Basing on Objective a. b. c. General hospitals Special hospitals Teaching cum Research Hospital 2. Basing on Administration, ownership, control or financial income a. b. c. d. Governmental or public Non-governmental or private Semi Govt Hospital Voluntary Agency Hospitals 3. Basing on Length of Stay a. b. Short-term or short-stay hospitals (Stay less than 30 days) Long-term or long-stay hospitals: (Stay more than 30 days) 4. Depending on Type of Medical Staff a. b. Closed-staff hospital: Open-staff hospital:

8. 5. Basing on bed capacity (Size) a. b. c. Small hospital (Upto 100 beds) Medium hospital (More than 100 to less than 300 beds) Large hospital (More than 300 beds) 6. Basing on type of care: a. b. c. Primary Care Secondary Care Tertiary Care 7. By teaching affiliation: a. b. Teaching hospital Non-teaching hospital 8. Basing on system of medicine a. b. c. d. e. Allopathic hospital Ayurvedic hospital Homeopathic hospital Unani hospital Hospitals of other system of medicine

9. 9. Basing on regionality a. b. c. R egion a l District Upazila Health Complex Union Health and Family Welfare Centres Community Clinics 10. As per WHO Classification : a. b. c. Regional Hospital Intermediate/ District Hospital Rural Hospital

10. General hospitals: General Hospitals are meant to provide wide-range of various types of healthcare, but with limited capacity. They care for patients with various-disease conditions for both sexes to all ages, medical, surgical, paediatrics, obstetrics, eye and ear etc. Usually, General hospitals are devoid of super-specialist medical care. Special hospitals: condition, orthopedics, They limit their service to a particular maternity, paediatrics, geriatrics, oncology etc. Teaching cum Research Hospital: College is attached for medical/ nursing/ dental/ pharmacy education. Main objective is to provide medical care, teaching and research is secondary

11. Governmental or public hospital : They are owned, administered and controlled by the government. They provide free care for patients. The governmental hospitals are owned by: The Ministry of Health. The University Others. A public hospital or government hospital is a hospital which is owned by a government and receives government funding. In some countries, this type of hospital provides medical care free of charge, the cost of which is covered by government reimbursement. In Australia, public hospitals are operated and funded by each individual state's health department. The federal government also contributes funding.

12. Private Hospital: Privately owned or controlled by an individual or group of physicians or citizens or by private organization. eg, Square Hospital. Purpose is to provide services for profit making. Semi Govt Hospital: Hospitals run both by the govt and private entity. eg Cantt Board Hospital.

13. Corporate Hospital Hospitals which are public limited companies formed under the companies act. Run on commercial lines. eg, Apollo Voluntary Agency Hospital: Not for profit hospitals by the Voluntary Organizations. eg, HOPE Foundation Fistula Hospital

14. Short-term or short-stay hospitals: These are hospitals where over 90% of all patients admitted stay less than 30 days. Long-term or long-stay hospitals: These are hospitals where over 90% of all patients admitted stay 30 days or more, i.e. mental hospital. Closed-staff hospital: Physicians are held responsible for all medical activities in the hospital including the diagnosis and treatment of patient fee paying and emergency. Open-staff hospital: This type of hospital permits other physicians in the community to admit and treat patients to the hospital' and treat them.

15. Open Staff Hospital: Open medical staff , which means any physician can request to practice at the facility, regardless of their hospital affiliation. Close Staff Hospital: A closed hospital system is one in which all doctors are on staff , and also doctors that aren't on staff may not have access or privileges at said hospital.

16. CLASSIFICATIONS OF HEALTH CARE Primary Care Secondary Care Tertiary Care

17. Primary Care  Co n s i s t s of b a s i c curative c a r e , i nc l uding si mp l e d iag n o s i s a n d treatment, provided at the point of entry into the health care system. (Example: walk-in-clinic)

18. Secondary Care  Consists of specialized s o p h i s ti c a te d a nd c o mp l i c a te d d i a g n o s i s c a r e r e q u i r i n g m o r e a n d treatment than is provided at the primary health care level. Normally involves hospitalization . (Example: Patient ward in general hospital)

19. Tertiary Care  Consists of highly specialized diagnostic and therapeutic services which can usually only be provided in centers specifically designed staffed and equipped for this purpose. (Example: Neonatal intensive care unit)

20. WHO Classification (Expert Committee 1957) Regional Hospital: Provides complex range of treatment and highly specialized services. Se r v es a la r g er a r ea than a lo c al h o spi t a l . E x ampl e - Go v t Medi c al College Hospital Intermediate/ District Hospital: A district hospital typically is the major health care facility in its locality (For Bangladesh in a district level). Specialty services in major disciplines (eg, Medicne, Surgery, Gynae etc) Rural Hospital: Remote hospitals with small number of beds and limited service capacity. It should have 20-100 beds. Upazila Health Complex in Bangladesh

21. ORGANIZATION OF HOSPITALS : ORGANIZATION is defined as “A DYNAMIC PROCESS, in which various MANAGERIAL ACTIVITIES bring & bind people together, for the ACHIEVEMENT of COMMON GOALS & OBJECTIVES” Most important BODY of a hospital is the GOVERNING BODY/ BOARD OF DIRECTORS/ BOARD OF TRUSTEES GOVERNING BODY  Consists of various eminent personalities in the field of : MEDICAL EDUCATION RESEARCH c. ADMINISTRATION d. POLITICS (Optional) 4. Function of GOVERNING BODY is to FRAME all major POLICIES, PLANS & PROGRAMMES of hospital

22. 5. GOVERNING BODY  Appoints a HOSPITAL ADMINISTRATOR to get various functions performed like CLINICAL SERVICES, NURSING, PHARMACY SERVICES, e tc…….

23. THE MEDICAL STAFF

24. Doctors represent the initiators of every action that results in the direct provision of patient care services.

25. Doctors determine:  Who Will Be Admitted  When  Where  What Medical Services Are to Be Provided, in What Sequence, in What Dosage, With What Equipment and Supplies When, Where and by Whom  Who Is Discharged and When.

26. Medical Staff  Participation by the medical staff in the decision-making process is in the best interest of both the hospital and the patients.  Physician involvement leads to physician accountability.

27. Medical Staff  The chief of medical staff is the elected representative of the medical staff.  The chief of staff appoints all of the committees other than the executive committee whose members are elected by the staff or appointed by the board administrator.

28. Functions of the Medical Staff  To advise the governing body on medical affairs.  To accept accountability for the quality of care rendered to patients in the hospital.  To request, review and act upon reports of medical staff committees.  To scrutinize the professional ethics of its members and to initiate corrective action as indicated.  To develop, implement, and review medical staff policies.

29. Functions of the Medical Staff  To recommend action to the administrator on all medical- administrative matters.

30. S E R V I C E S P E R F O R M E D B Y H O S P I T A L O R G A N I ZA T I O N : Include: A. NURSING SERVICES: LARGEST part of a hospital Functions all 24 hours - Nurses  assigned specific number of beds  have to give personal attention to patients Nurses are trained for PRENATAL CARE, OBSERVATION, PATIENT COMFORT DURING LABOUR, etc. NURSING DIRECTOR is the in-charge of NURSING SERVICES……….

31. B. OUT-PATIENT SERVICES: Focus on COMFORT for OUT-PATIENTS, as the approach for major/minor illnesses These services  make a hospital an IDEAL COMMUNITY INSTITUTION Hospital is duty-bound to provide DIAGNOSTIC, PREVENTIVE & CURATIVE measures to the OUT-PATIENTS………………….

32. 3. RADIOLOGICAL SERVICES: Performed under direction of a competent RADIOLOGIST CHIEF RADIOLOGIST  assisted by various TECHNICIANS Services include UTILIZATION of EQUIPMENTS like: SONOGRAPHY X-RAY ECG CT-SCAN, etc……………

33. 4. CENTRAL SUPPLY SERVICES: Refers to MEDICAL & SURGICAL SUPPLY SERVICES Meant for DIAGNOSIS, TREATMENT, PREVENTION, EDUCATION & RESEARCH Involves their COLLECTION, PROCESSING, STORAGE & ISSUANCE against proper INDENT FORM Qualified & skilled staff personnel are responsible for its maintenance…………………

34. 5. HOSPITAL PHARMACY SERVICES: Controls PHARMACY OPERATION in any hospital FILLS PRESCRIPTION & no. of NECESSITIES from wards Functions begin from DRUG PROCUREMENT to DISTRIBUTION to I.P and O.P Responsible for : PROPER DRUG DELIVERY INFORMATION SYSTEM DRUG STORAGE MANUFACTURE STERILIZATION ADVICING PATIENT ON DRUG USE

35. 6. MEDICAL RECORD SERVICES: VALUABLE MATERIALS, as they help MEDICAL & PARA-MEDICAL STAFF for EVALUATION Also used for EDUCATION, RESEARCH & TRAINING Consists of : PATIENT HISTORY LAB- TEST REPORTS c. PHYSICAL EXAMINATION DETAILS d. PHYSICAN’S ADVICE, etc. - It is mandatory to store medical records properly to FACILITATE EASY ACCESS on requirement…………………..

36. 7. STORE SERVICES: RECEIVE, STORE & ISSUE materials against REQUISITION FORMS of various DEPARTMENTS & WARDS Hospital consists of: MEDICAL STORE STORE FOR GENERAL ITEMS SURGICAL STORES, etc - Maintain a BUFFER STOCK of certain materials, including LIFE-SAVING DRUGS…………………….

37. 8. MISCELLANEOUS SERVICES: Aimed at overall BENEFIT & PATIENT CARE Include: DIETARY SERVICES AMBULATORY SERVICES LAUNDRY SERVICES TRANSPORT SERVICES MORTUARY SERVICES LIBRARY SERVICES………………………….

38. THANK YOU!!!